Abstract
Chronic pain is a debilitating clinical condition associated with a variety of disease
entities including diabetic neuropathy, postherpetic neuralgia, low back pathology,
fibromyalgia, and neurological disorders. For many general practitioners and specialists,
managing chronic pain has become a daunting challenge. As a modality of multidisciplinary
chronic pain management, medications are often prescribed in combinations, an approach
referred to as combination drug therapy (CDT). However, many medications for pain
therapy, including antidepressants and opioid analgesics, have significant side effects
that can compound when used in combination and impact the effectiveness of CDT. To
date, clinical practice of CDT for chronic pain has been based largely on clinical
experiences. In this article, we will focus on (1) the scientific basis and rationales
for CDT, (2) current clinical data on CDT, and (3) the need for more clinical studies
to establish a framework for the use of CDT.
Perspective
More preclinical, clinical, and translational studies are needed to improve the efficacy
of combination drug therapy that is an integral part of a comprehensive approach to
the management of chronic pain.
Key words
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Article info
Publication history
Published online: September 20, 2010
Footnotes
Supported by NIH RO1 grants NS45681, DA22576, DE18214, DE18538, DE018252, NS063010, and P20 grant DA26002.
The authors declare no conflict of interest.
Identification
Copyright
© 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.
